Highly Prevalent SARS-CoV-2 Antigenemia in COVID-19 Patients

Background:Many issues, such as severity assessment and antibody responses, remain to be answered eagerly for evaluation and understanding of COVID-19. Immune lesion is one of key pathogenesis of the disease. It would be helpful to understand the disease if an investigation on antigenemia and association was conducted in the patients with SARS-CoV-2 infection.Methods:A total of 156 patients admitted to the First People's Hospital of Hefei or Anhui Provincial Hospital on January to February 2020 were involved in this study. SARS-CoV-2 nucleocapsid (NP) antigen, specific IgM/IgG antibodies, and RNA were detected in sequential sera from three COVID-19 patients, and additional 153 COVID-19 patients by means of NP-antigen capture enzyme-linked immunosorbent assay, colloidal gold quick diagnosis, and real-time RT-PCR, respectively. The clinical types of COVID-19 patients were classified into asymptomatic, mild, moderate, severe, and critical, following on the Chinese guideline of COVID-19 diagnosis and treatment. The demographic and clinical data of patients were obtained for comparable analysis.Results:NP antigen was detected in 5 of 20 sequential sera collected from three COVID-19 patients with typically clinical symptoms, and 60.13% (92/153) expanded samples collected within 17 days after illness onset. No SARS-CoV-2 RNA segment was detected in these sera. The NP positive proportion reached a peak (84.85%, 28/33) on 6 to 8 days after illness onset. Both NP concentration and positive proportion were increased with the increase of clinical severity of COVID-19. Compared to NP negative patients, NP positive patients had older age [years, medians (interquartile ranges (IQR)), 49 (6) vs. 31 (11)], lower positive proportion of NP specific IgM [27.17% (25/92) vs. 59.02% (36/61)], and IgG [21.74% (20/92) vs. 59.02% (36/61)] antibodies, and longer duration [days, medians (IQR), 24 (10) vs. 21 (13)] from illness to recovery.Conclusions:SARS-CoV-2 NP antigenemia occurred in COVID-19, and presented highly prevalent at early stage of the disease. The antigenemia was related to clinical severity of the disease, and may be responsible for the delay of detectable SARS-Cov-2 IgM. © 2022 Journal of Bone and Joint Surgery Inc.. All rights reserved.

Specific measures to response pandemic of COVID-19 in China: A systematic review

Contemporarily, the novel Coronavirus (SARS-CoV-2, abbreviation for COVID-19) has raged around the world in a short time, which attracts the attention of countries around the world. This virus is spreading fast with a considerable impact, posing a huge threat to global public health. The challenges COVID-19 presented require a robust response. As the world,s best country in epidemic control, China has done a lot of control measures. These measures include laboratory confirmation, social distancing and vaccine. Evidences have proved that these measures taken by China have effectively reduced the incidence and mortality of COVID-19 in China. This article will provide a systematic review of these control measures in China, in the hope ofproviding information for global infectious disease control. © The Authors, published by EDP Sciences.

Virtual screening and activity study of antiviral compounds targeting inosine 5'-monophosphate dehydrogenase

Inosine 5'-monophosphate dehydrogenase (IMPDH) is a key enzyme catalyzing the rate-limiting step of de novo nucleotide synthesis in vivo. In recent years, it has become a therapeutic target for anti-virus, antibacterial, anti-cancer, anti-parasitic and other diseases. IMPDH inhibitors have been shown to inhibit viral proliferation in host cells by depleting guanosine 5'-monophosphate (GMP), the raw material required for viral replication in host cells, with broad-spectrum antiviral properties. In order to find novel anti-coronavirus drugs, this study screened 22 potential IMPDH inhibitors from 70 000 natural small molecule libraries based on IMPDH protein structure using molecular docking and ROC calculation for virtual screening. With ribavirin as the positive control drug, Huh7 cell and H460 cell models were used to verify the anti-coronavirus HCoV-229E and HCoV-OC43 activities of 22 selected target compounds. Among them, compounds 11, 12, 15 and 16 showed inhibitory activity against coronavirus HCoV-229E. The compounds 4, 12, 13 and 15 showed inhibitory activities against coronavirus HCoVOC43. 12 and 15 showed significant inhibitory activity against both two coronaviruses, and their efficacy was similar to ribavirin at the same dose, which can be further studied as a lead compound for IMPDH inhibitors. Copyright © 2022, Chinese Pharmaceutical Association. All rights reserved.

[Clinical characteristics of 16 neonates infected with SARS-CoV-2 during Omicron variant outbreak].

Objective: To analyze the clinical characteristics of the neonates infected with SARS-CoV-2 during the Omicron outbreak in Shanghai 2022. Methods: In this retrospective case series study, all the 16 neonates with SARS-CoV-2 Omicron infection who were admitted to the neonatal unit in Shanghai Public Health Clinical Center from March 1st to May 31st, 2022 were enrolled. Their epidemiological history, clinical manifestations, nucleic acid cycle threshold (Ct) value and outcomes were analyzed. Based on maternal vaccination, they were divided into vaccinated group and unvaccinated group. Rank sum test and Chi-square test were used for the comparison between the groups. Results: Among the 16 neonates, 10 were male, and 6 were female. All the infants were full-term. The infection was confirmed at the age of 12.5 (8.0, 20.5) days. All the neonates had a history of exposure to infected family members, and thus horizontal transmission was the primary mode. Four infants were asymptomatic, 12 were symptomatic, and there were no severe or critical cases. The most common clinical manifestation was fever (11 cases), with the highest temperature of 38.1 (37.9, 38.3) ℃ and a course of 1-5 days. Other clinical manifestations included nasal obstruction (3 cases), runny nose (2 cases), cough (2 cases), poor feeding (2 cases), vomiting (1 case), and mild tachypnea (1 case). The complete blood counts of all neonates were within the normal range, and the C-reactive protein increased slightly in 1 infant. Chest imaging was performed in 2 infants, showing mild focal exudative changes. Nucleic acid turned negative (Ct value ≥35) within 7-15 days after diagnosis. All neonates fully recovered after supportive treatment, and the length of hospitalization was 13 (10, 14) days. In the telephone follow-up 2 weeks after discharge for all 16 cases, no infant showed reoccurrence of clinical manifestations or nucleic acid reactivation. Maternal vaccination was not significantly correlated with symptomatic infection or the persistence of positive nucleic acid result in neonates (all P>0.05). Conclusions: Horizontal transmission is the primary mode for neonatal SARS-CoV-2 Omicron infection. Neonatal infections are usually mild or asymptomatic, with good short-term outcomes. And their clinical manifestations and laboratory examinations are nonspecific.

[Management and short-term outcomes of neonates born to mothers infected with SARS-CoV-2 Omicron variant].

Objective: To summarize the management and short-term outcomes of neonates delivered by mothers infected with SARS-CoV-2 Omicron variant. Methods: A retrospective study was performed on 158 neonates born to mothers infected with SARS-CoV-2 Omicron variant admitted to the isolation ward of Children's Hospital of Fudan University from March 15th, 2022 to May 30th, 2022. The postnatal infection control measures for these neonates, and their clinical characteristics and short-term outcomes were analyzed. They were divided into maternal symptomatic group and maternal asymptomatic group according to whether their mothers had SARS-CoV-2 symptoms. The clinical outcomes were compared between the 2 groups using Rank sum test and Chi-square test. Results: All neonates were under strict infection control measures at birth and after birth. Of the 158 neonates, 75 (47.5%) were male. The gestational age was (38+3±1+3) weeks and the birth weight was (3 201±463)g. Of the neonates included, ten were preterm (6.3%) and the minimum gestational age was 30+1 weeks. Six neonates (3.8%) had respiratory difficulty and 4 of them were premature and required mechanical ventilation. All 158 neonates were tested negative for SARS-COV-2 nucleic acid by daily nasal swabs for the first 7 days. A total of 156 mothers (2 cases of twin pregnancy) infected with SARS-CoV-2 Omicron variant, the time from confirmed SARS-CoV-2 infection to delivery was 7 (3, 12) days. Among them, 88 cases (56.4%) showed clinical symptoms, but none needed intensive care treatment. The peripheral white blood cell count of the neonates in maternal symptomatic group was significantly higher than that in maternal symptomatic group (23.0 (18.7, 28.0) × 109 vs. 19.6 (15.4, 36.6) × 109/L, Z=2.44, P<0.05). Conclusions: Neonates of mothers infected with SARS-CoV-2 Omicron variant during third trimester have benign short-term outcomes, without intrauterine infection through vertical transmission. Strict infection control measures at birth and after birth can effectively protect these neonates from SARS-CoV-2 infection.

[Spatiotemporal evolution of COVID-19 epidemic in the early phase in China].

Objective: Based on the geographic information systems, we exploreed the spatiotemporal clustering and the development and evolution of COVID-19 epidemic at prefectural level in China from the time when the epidemic was discovered to the time when the lockdown ended in Wuhan. Methods: The information and data of the confirmed COVID-19 cases from December 8, 2019 to April 8, 2020 were collected from 367 prefectures in China for a spatial autocorrelation analysis with software GeoDa, and software ArcGIS was used to visualize the results. Software SatScan was used for spatiotemporal scanning analysis to visualize the hot-spot areas of the epidemic. Results: The incidence of new cases of COVID-19 had obvious global autocorrelation and the partial autocorrelation results showed that incidence of COVID-19 had different spatial distribution at different times from December 8, 2019 to March 4, 2020. There was no significant difference in global autocorrelation coefficient from March 5, 2020 to April 8, 2020. The statistical analysis of spatiotemporal scanning identified two kinds of spatiotemporal clustering areas, the first class clustering areas included 10 prefectures, mainly distributed in Hubei, from January 13 to February 25, 2020. The secondary class clustering areas included 142 prefectures, mainly distributed in provinces in the north and east of Hubei, from January 23 to February 1, 2020. Conclusions: There was a clear spatiotemporal correlation in the distribution of the outbreaks in the early phase of COVID-19 epidemic (December 8, 2019-March 4, 2020) in China. With the decrease of the case and effective prevention and control measures, the epidemics had no longer significant correlations among areas from March 5 to April 8. The study results showed relationship with time points of start and adjustment of emergency response at different degree in provinces. Furthermore, improving the early detection of new outbreaks and taking timely and effective prevention and control measures played an important role in blocking the transmission.

WHY THE PURCELL PRINCIPLE SHOULD BE ABOLISHED

The Supreme Court seeks to promote orderly and effective voting through the Purcell principle, which prohibits district courts from altering election rules via injunctions on the eve of an election. Applying this principle, a court considers only the proximity of the upcoming election. The underlying rationale of the Purcell principle is to avoid possible voter confusion and election chaos caused by lastminute changes. While these are legitimate concerns, the rigid Purcell principle has led courts to blindly reject any changes proposed shortly before the election—even when the changes are necessary for an orderly, effective election. This Note identifies the drawbacks of the Purcell principle and argues for its abolition. In other words, courts should cease applying the Purcell principle and return to the Winter preliminary injunction standard, which requires courts to weigh plaintiffs’ likelihood of success on the merits, any irreparable harm to parties, the balance of equities, and the public interest. The Purcell principle is ambiguous in three key ways: whether it is a stand-alone rule or a subfactor;how close the election has to be for the principle to apply;and whether it applies to appellate decisions in addition to district courts’ orders. The consistent failure of the judiciary to clarify the principle in the hundreds of Purcell cases generated by the COVID-19 pandemic demonstrates that revising Purcell is impracticable. Copyright © 2022 Ruoyun Gao.

Finger Vein Image ROI Extraction Based on Active Contour Method

Under the background of the novel coronavirus pneumonia outbreak in the world, unrestricted and contactless finger vein collection devices have significantly improved public health safety. However, due to the unfixed position of the finger and the open or semi-open characteristics of the acquisition device, it is inevitable to introduce plenty of factors that affect the recognition performance, such as low contrast, uneven illumination and edge disappearance. In view of these practical problems, we propose a method for ROI extraction of finger vein images that combines active contour method and morphological post-processing operations. This method starts from the local segmentation, and finally completes the acquisition of finger masks at the global level, and then combines some morphological operations to achieve precise extraction of finger masks. We designed and conducted plenty of comparison experiments on the proposed algorithm and the current mainstream finger vein image ROI extraction methods on three public available finger vein datasets. Experimental results show that our method accurately extracts the complete finger region mask and achieves the best matching accuracy on all datasets. © 2022 Institute of Physics Publishing. All rights reserved.

[Investigation of contamination of SARS-CoV-2 in imported frozen seafood from a foreign cargo ship and risk factors for infection in stevedores in Qingdao].

Objective: To investigate the contamination status of SARS-CoV-2 in imported frozen seafood from a Russia cargo ship in Qingdao and to analyze the risk factors for infection in local stevedores. Methods: The method of "two-stage, full coverage and mixed sampling" was used to collect the seafood packaging samples for the nucleic acid detection of SARS-CoV-2 by real-time fluorescent quantitative RT-PCR. A unified questionnaire was designed to investigate 71 stevedores in two shifts through telephone interview. The stevedores were divided into two groups, with 23 in the shit with two infections was group A and 48 in the shift without infection was group B. Software Epi Info7.2 was used to identify the risk factors for SARS-CoV-2 infections in the stevedores. Results: In the frozen seafood from a Russia cargo ship, the total positive rate of SARS-CoV-2 nucleic acid in the frozen seafood was 11.53% (106/919). The positive rate of SARS-CoV-2 nucleic acid in the frozen seafood unloaded by group A (14.29%,70/490) was significantly higher than that in the frozen seafood unloaded by group B (8.39%,36/429)(χ2=7.79,P=0.01) and the viral loads detected in the frozen seafood unloaded by group A were higher than those detected in the frozen seafood unloaded by group B. The scores of personal protection and behaviors in the stevedores in group A were significantly lower than those in group B (P<0.05), and toilet use, smoking and improper hand washing before meals were the risk factors for the infection. Conclusions: The imported frozen seafood was contaminated by SARS-CoV-2 and the contamination distribution was uneven. Supervision and management of personal occupational protection and behaviors of workers engaged in imported frozen food transportation should be strengthened. It is suggested that a closed-loop monitoring and management system for the whole process of "fishing-transport- loading/unloading" should be established by marine fishery authority.

Impacts of COVID-19 pandemic on the diagnosis of gastrointestinal cancer: A single center study

Objective: COVID-19 pandemic has rapidly spread all over the world. However, the impacts of the COVID-19 pandemic on gastrointestinal cancer are unclear. This is the first study to evaluate the impact of COVID-19 pandemic on gastrointestinal cancer diagnosis based on patient gender, patent age and diagnosis time stratification. Methods: The frequencies of gastrointestinal cancer diagnosed were compared between the COVID-19 epidemic period (from 24 January to 30 April 2020) and the same period in the previous year. A linear model was constructed to predict the impact of COVID-19 outbreak on gastrointestinal cancer diagnosis. Results: A significant decline was found in upper endoscopy and lower endoscopy (4,863 vs 8,941 and 2,749 vs 3,979, respectively) during the study period. Moreover, diagnosed gastrointestinal cancer, including early esophageal cancer, advanced esophageal cancer, early gastric cancer and advancer gastric cancer, was prominently dropped by 50%, whereas the number of diagnosed colorectal cancer was reduced by 13.3%. Furthermore, the linear model revealed that the patients over 60 years old were associated with the delay on the diagnosis of gastrointestinal cancer, which indicated that these patients were prioritized accessing to upper and lower endoscopy in post-pandemic period. Conclusions: COVID-19 pandemic resulted in substantial drop in the diagnosis of gastrointestinal cancer. However, the high-risk groups with delay on gastrointestinal cancer diagnosis had priority for endoscopy procedure, which may offset the deleterious effects of the COVID-19 outbreak on gastrointestinal cancer diagnosis in postpandemic period.

COVID-19 Reverse Prediction and Assessment on the Diamond Princess Cruise Ship

As of July 21, 2020, the coronavirus SARS-CoV-2 had spread to almost all countries around the world and caused more than 14.8 million confirmed cases, owing to its high transmissibility and fast rate of spread. Of the infected locations, the Diamond Princess cruise ship is special in that it is an isolated system with a population highly concentrated in a limited space, providing particularly favorable conditions for the transmission of the novel coronavirus-associated pneumonia, COVID-19. The Japanese government's emergency measures for controlling the spread of COVID-19 on the cruise ship have also been questioned. In this paper we develop a homogeneous mixed difference system to describe the mechanism of transmission of COVID-19 on the cruise ship, reverse-predict the epidemic transmission trend from January 20 to February 20, 2020, including the daily number of infected people and the peak time of infection, estimate the range of the basic reproduction number of virus transmission on the cruise ship, and assess the effects of prevention and control measures. It is concluded that the isolation of people, along with rapid and comprehensive detection of infections, play an important role in controlling the epidemic. In fact, the Japanese government's emergency measures did have a certain effect on limiting the spread of COVID-19, but the number of infected people could have been reduced by at least 60% if all personnel on the cruise ship had been tested and isolated promptly as early as February 5. © Copyright © 2020 Zhang, Sun, Li, Gao, Ren, Pei and Jin.